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2024

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* 1. I know the mission of Mended Reeds Services?

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* 2. Mended Reeds has a person-centered philosophy?

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* 3. MRS is an advocate for me in the local community.

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* 4. I have access to the leadership of MRS?

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* 5. I know where to go at Mended Reeds or with whom to speak if I have a complaint.

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* 6. My concerns at Mended Reeds have been acknowledged and managed in a professional and timely manner.

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* 7. Mended Reeds assesses and acknowledges diversity of clients, staff, and community members.

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* 8. Mended Reeds respects and incorporates my attitudes and beliefs throughout its services.

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* 9. Mended Reeds demonstrates understanding and respect my attitudes about sexual orientation, gender identity, and gender expression.

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* 10. I am comfortable disclosing spiritual beliefs, observances, and holiday preferences to Mended Reeds.

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* 11. MRS guards my safety in every type of emergency: medical, fire, tornado, active shooter, etc.

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* 12. I feel safe while at Mended Reeds and on its property.

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* 13. The buildings and properties are clean, safe and well-maintained.

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* 14. Mended Reeds provides adequate facilities (e.g., offices, parking, common areas) to meet my needs.

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* 15. Overall, I am satisfied with Mended Reeds buildings and properties.

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* 16. The organization’s services are available at times that are good to me.

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* 17. Mended Reeds has adequate technology, equipment, and training to assist me in meeting my goals.

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* 18. Mended Reeds has adequate transportation to meet my needs.

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* 19. Mended Reeds vehicles are safe, clean and well-maintained.

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* 20. Please check any of the below that serve as a barrier to meeting your needs at Mended Reeds:

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* 21. Additional feedback regarding the Organization and Leadership:

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* 22. The people who work at Mended Reeds treat me with dignity and respect.

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* 23. Mended Reeds staff has adequate knowledge and training to help me meet my needs.

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* 24. The staff is respectful of my confidentiality and privacy.

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* 25. Overall, I am satisfied with the services that I am receiving.

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* 26. I was given written information about my rights and responsibilities as a consumer/client.

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* 27. I was able to begin services in a reasonable timeframe.

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* 28. Initial intake at MRS was efficient and thorough.

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* 29. I help plan my services and set my own individualized goals.

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* 30. Mended Reeds involve my family members and loved ones appropriately in my treatment plan.

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* 31. I am aware of the process to transition to a different level of care.

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* 32. I have a tentative aftercare plan.

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* 33. My medication needs are addressed at Mended Reeds.

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* 34. I have been given adequate information about my medications.

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* 35. I am satisfied with the telehealth options at Mended Reeds.

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* 36. I was adequately trained to utilize telehealth services.

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* 37. I prefer sessions with my therapist to be:

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* 38. During Telehealth sessions, my therapist is engaged with me and our session without outside distractions.

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* 39. Case Management services help me meet my overall treatment goals.

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* 40. I believe my case manager is able to help me with my problems.

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* 41. Counseling services help me meet my overall treatment goals.

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* 42. I believe my therapist is able to help me with my problems.

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* 43. Medical services help me meet my overall treatment goals.

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* 44. I believe my medical provider is able to help me with my problems.

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* 45. Please provide any feedback regarding particular staff members:

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* 46. Please indicate which services you believe need further developed or added:

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* 47. Please provide any feedback for improving your services at Mended Reeds:

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* 48. I am a client/consumer of this program

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* 49. Age:

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* 50. Birth Sex:

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* 51. Gender identity:

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* 52. Sexual orientation:

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* 53. Race (select all that apply):

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* 54. Ethnicity

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